Advances in burn care

Research output: Contribution to journalReview article

17 Scopus citations

Abstract

PURPOSE OF REVIEW: This article reviews and critiques new developments in the critical care of burn patients. RECENT FINDINGS: The practice of restrictive transfusion is slowly gaining traction. Abdominal compartment syndrome is associated with resuscitation volumes of 300 ml/kg per 24 h, and percutaneous decompression may be a treatment option. Adrenal insufficiency is common, but whom and when to treat are unclear. Imaging or noninvasive monitoring may confirm renal perfusion before urine output, and the concept of permissive hypovolemia should be explored. There is progress in the laboratory in smoke inhalation and myocardial depression, but no human translation. Antibiotic pharmacokinetics in large burns are unpredictable, and so aminoglycosides (measurable concentrations) are not obsolete. Selective digestive decontamination remains controversial. Nutritional predictions by formula are inaccurate. Oxandrolone is safe and effective in promoting anabolism in large burns. Deep venous thrombosis prophylaxis remains guided only by expert opinion. Females fare worse than male patients after burns. SUMMARY: The application of the scientific method to burn care is improving slowly. Randomized controlled trials are becoming more common. There is a need for translation of excellent animal work to the human arena.

Original languageEnglish (US)
Pages (from-to)405-410
Number of pages6
JournalCurrent Opinion in Critical Care
Volume13
Issue number4
DOIs
StatePublished - Aug 1 2007

Keywords

  • Abdominal compartment syndrome
  • Burns
  • Resuscitation
  • Smoke inhalation
  • Thermal injuries

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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